In the first 24 hours after a blunt eye injury, blood may leak into the skin of the eyelid and surrounding areas, causing swelling and a bruise (contusion), commonly called a black eye. The blood usually drains toward the bottom of the eyelids after a day or two, resulting in swelling and discoloration just below the lower eyelid. Black eyes themselves have no effect on vision, although other eye injuries that accompany them may be serious.
Black eyes resolve without treatment after a few days or weeks. During the first 24 to 48 hours, ice packs may help reduce swelling and ease the pain of a black eye.
Nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin or ibuprofen) or acetaminophen can be given if the pain is significant. However, people who have bleeding within the eye should probably use acetaminophen and not use NSAIDs, which may worsen bleeding.